Addressing Anxiety in Hospitalized Adults Using a Music Intervention

Abstract

Practice Problem: The practice problem is anxiety related to hospitalization among adults in an acute care setting. Increased anxiety can lead to other issues while hospitalized including disruptive behaviors. PICOT: The PICOT question that guided this project was: In hospitalized medical-surgical adults (P), how does the implementation of a music intervention as an adjunct to standard distraction techniques (I) compared to standard care (C) affect symptoms of anxiety as observed by the rate of behavior de-escalation team calls (O) within eight weeks (T)? Evidence: There were five systematic reviews, four systematic reviews with meta-analysis with high level of evidence, high quality rating, and high quantity of articles included emerged that led to the project. Evidence supported the use of a music intervention for therapeutic distraction and reduction of anxiety. Intervention: The intervention was a music intervention of a personalized music selection for approximately 30 minutes prior to procedures or when anxiety or disruptive behavior was noted in addition to standard care. Outcome: Music intervention use increased by 68 individual sessions during the intervention period from baseline. Utilization of the de-escalation team decreased 80% from the preceding 10 weeks prior to implementation. Data collection difficulties reduced observation of knowledge change, however, activities related to the intervention increased during the intervention period. Conclusion: The use of music as an intervention to decreasing anxiety and the use of a de-escalation team for disruptive behavior was successful though the process outcomes were not met. Staff engagement will be key in making this a sustainable practice and additional interventions for staff engagement are necessary.